What should I discuss with my healthcare provider before using tinzaparin (Innohep)?

You should not use this medication if you are allergic to tinzaparin, heparin, sulfites, benzyl alcohol, or pork products, or if you have:

active or uncontrolled bleeding; or

if you have ever had low platelet counts after receiving heparin.

Tinzaparin may cause you to bleed more easily, especially if you have:

a bleeding disorder that is inherited or caused by disease;

hemorrhagic stroke;

an infection of the lining of your heart (also called bacterial endocarditis);

uncontrolled high blood pressure;

stomach or intestinal bleeding or ulcer;

liver failure;

kidney disease (especially if you are an older adult);

recent brain, spine, or eye surgery; or

amyloidosis (a build-up of certain proteins in tissues and organs of the body).

Tinzaparin can cause a very serious blood clot around your brain or spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). This type of blood clot could cause long-term paralysis, and may be more likely to occur if you have:

a genetic spinal defect;

a history of spinal surgery or repeated spinal taps; or

if you are using other medications to treat or prevent blood clots.

To make sure you can safely use tinzaparin, tell your doctor if you have other medical conditions, especially:

recent stomach ulcer; or

eye problems caused by diabetes.

FDA pregnancy category B. Tinzaparin is not expected to harm an unborn baby. However, some forms of this medication contain a preservative that may be harmful to a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether tinzaparin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use tinzaparin (Innohep)?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Tinzaparin is usually given every day until your bleeding condition improves. Follow the directions on your prescription label.

Tinzaparin must not be used as a substitute for heparin. These two drugs are manufactured differently and have different dosages.

Tinzaparin is injected under the skin. You may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

You should be sitting or lying down during the injection. Do not inject tinzaparin into a muscle or a vein.

Use a different place on your stomach each time you give the injection. Your care provider will show you the best places on your body to inject the medication. Do not inject into the same place two times in a row.

Prepare your dose in a syringe only when you are ready to give yourself an injection. Do not use the medication if it has changed colors or has particles in it. Call your doctor for a new prescription.

Use a disposable needle only once. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Tell any doctor who treats you that you are using tinzaparin. If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using this medication.

To be sure this medication is not causing harmful effects, your blood and your stool (bowel movement) may need to be tested often. Your nerve and muscle function may also need to be tested. Visit your doctor regularly.